Demographic and clinical correlates of substance abuse comorbidity in schizophrenia (original) (raw)

Prevalence of Substance Abuse in Schizophrenia: Demographic and Clinical Correlates

Schizophrenia Bulletin, 1990

Methodological issues involved in assessing the prevalence of substance abuse in schizophrenia are discussed, and previous research in this area is comprehensively reviewed. Many studies surfer from methodological shortcomings, including the lack of diagnostic rigor, adequate sample sizes, and simultaneous assessment of different types of substance abuse (e.g., stimulants, sedatives). In general, the evidence suggests that the prevalence of substance abuse in schizophrenia is comparable to that in the general population, with the possible exceptions of stimulant and hallucinogen abuse, which may be greater in patients with schizophrenia. Data are presented on the association of substance abuse with demographics, diagnosis, history of illness, and symptoms in 149 recently hospitalized DSM-III-R schizophrenic, schizophreniform, and schizoaffective disorder patients. Demographic characteristics were strong predictors of substance abuse, with gender, age, race, and socioeconomic status being most important. Stimulant abusers tended to have their first hospitalization at an earlier age and were more often diagnosed as having schizophrenia, but did not differ in their symptoms from nonabusers. A history of cannabis abuse was related to fewer symptoms and previous hospitalizations, suggesting that more socially competent patients were prone to cannabis use. The findings show that environmental factors may be important determinants of substance abuse among schizophrenicspectrum patients and that clinical differences related to abuse vary with different types of drugs.

Prevalence of Substance Abuse in Patients with Schizophrenia

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2020

Introduction: Substance abuse is a common comorbidity in patients of Schizophrenia. Link between the use of substances and development of psychosis is demonstrated by high prevalence of substance abuse in schizophrenia. Substance use disorders and their effects on schizophrenia have made identification and treatment of these patients a high priority. Aim: To study the prevalence of substance abuse, preferred types of substances of abuse and its association with socio demographic characteristics and clinical features of schizophrenia.

Substance abuse in schizophrenia

Social Psychiatry and Psychiatric Epidemiology, 2002

s Abstract Background Most of the information on the prevalence and patterns of substance abuse in patients with schizophrenia has been from studies conducted in North America and Europe and data from Asian countries are conspicuously lacking. This study was undertaken with the aim to identify the prevalence and patterns of substance abuse among patients with firstepisode schizophrenia in the city-state of Singapore. Methods All new patients with a diagnosis of firstepisode schizophrenia or schizophreniform disorder who were seen in one calendar year in the only state mental institute in Singapore and its affiliated outpatient clinics were evaluated for a lifetime history of substance use. Results In a sample of 272 patients, 201 (73.6 %) were abstainers, 43 (15.8 %) had "mild" substance use and 28 (10.3 %) had "heavy" use patterns. Alcohol was the most frequently abused substance. The substance users were more likely to be males and were more likely to have a criminal record than abstainers. Conclusions To our knowledge, this is the first study that examines the co-morbidity of substance abuse in schizophrenia in an Asian population. Our findings once again highlight the fact that patients with schizophrenia are at a high risk for substance abuse. s

Schizophrenia and substance use disorder: a retrospective study of a dual diagnosis patients cohort

Psychiatria, 2021

Introduction: Approximately 47% of patients with Schizophrenia have criteria for a dual diagnosis. The consumption of illicit substances, particularly cannabis, is quite prevalent in these patients, being associated with an increase in mortality and morbidity and worse social outcomes. This study aims to understand the relationship between Schizophrenia and substance use disorders (SUD). Material and methods: A retrospective study was designed, including patients diagnosed with schizophrenia admitted to the Psychiatric Ward between January 2017 and June 2019. Results: 205 patients were included, 49 women (23.9%) and 156 men (76.1%). Of these, 29.1% consumed psychoactive substances at the first hospitalization, mainly cannabis (24.1%), with higher prevalence in men. The average age at the first admission was significantly lower for substance users than for non-users. The presence of consumption in the first hospitalization, the number of hospitalizations and treatment adherence were ...

Comorbid substance-use in schizophrenia: Relation to positive and negative symptoms

Schizophrenia Research, 2006

As substance use disorders (SUD) are common in schizophrenia patients, we tested the hypothesis that comorbid patients (SUD [+]) have more positive vs. negative symptoms than non-comorbid (SUD[-]) patients. From reports identified by literaturesearching we compared Positive and Negative Syndrome Scale (PANSS) ratings in schizophrenia patients with and without SUD using meta-analytic methods. Among 9 comparisons (N = 725 subjects), SUD[+] patients were more often men, and abused alcohol > cannabis > cocaine. SUD[+] patients had very significantly higher PANSS-positive, and lower PANSS-negative scores. Comorbid SUD in schizophrenia patients was associated with male sex and higher PANSS positive to lower negative scores. Cause-effect relationships remain to be clarified.

Substance Use in Persons With Schizophrenia

The Journal of Nervous and Mental Disease, 2006

This study examined baseline correlates of substance use in the NIMH Clinical Antipsychotic Trials of Intervention Effectiveness project. Approximately 60% of the sample was found to use substances, including 37% with current evidence of substance use disorders. Users (with and without substance use disorders), compared with nonusers, were significantly more likely to be male, be African-American, have lower educational attainment, have a recent period of homelessness, report more childhood conduct problems, have a history of major depression, have lower negative symptom and higher positive symptom scores on the Positive and Negative Syndrome Scale, and have a recent illness exacerbation. Individuals with comorbid substance use disorders were significantly more likely to be male, report more childhood conduct problems, have higher positive symptom scores on the Positive and Negative Syndrome Scale, and have a recent illness exacerbation. These analyses suggest that substance use disorders in schizophrenia are especially common among men with a history of childhood conduct disorder problems and that childhood conduct disorder problems are potent risk factors for substance use disorders in schizophrenia.

Patterns of Current and Lifetime Substance Use in Schizophrenia

Schizophrenia Bulletin, 1998

A structured interview and standardized rating scales were used to assess a sample of 194 outpatients with schizophrenia in a regional Australian mental health service for substance use, abuse, and dependence. Case manager assessments and urine drug screens were also used to determine substance use. Additional measurements included demographic information, history of criminal charges, symptom self-reports, personal hopefulness, and social support. The sample was predominantly male and showed relative instability in accommodations, and almost half had a history of criminal offenses, most frequently drug or alcohol related. The 6-month and lifetime prevalence of substance abuse or dependence was 26.8 and 59.8 percent, respectively, with alcohol, cannabis, and amphetamines being the most commonly abused substances. Current users of alcohol comprised 773 percent and current users of other nonprescribed substances (excluding tobacco and caffeine) comprised 29.9 percent of the sample. Rates of tobacco and caffeine consumption were high. There was a moderate degree of concordance between case manager determinations of a substance-use problem and research diagnoses. Subjects with current or lifetime diagnoses of substance abuse/dependence were predominantly young, single males with higher rates of criminal charges; however, there was no evidence of increased rates of suicide attempts, hospital admissions, or daily doses of antipsychotic drugs in these groups compared with subjects with no past or current diagnosis of substance abuse or dependence. Subjects with a current diagnosis of substance use were younger at first treatment and currently more symptomatic than those with no past or current substance use diagnosis. The picture emerging from this study replicates the high rate of substance abuse in persons with schizophrenia reported in North American studies but differs from the latter in finding a slightly different pattern of substances abused (i.c, absence of cocaine), reflecting relative differences in the availability of certain drugs.

Clinical aspects of substance abuse in persons with schizophrenia

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2003

To review the current knowledge on the problem of psychoactive substance abuse by persons with schizophrenia, with particular attention to issues of direct relevance to clinical practice. The author examined the literature from the last 2 decades and data from studies in which he was involved. Schizophrenia sufferers show an elevated liability for substance abuse. Such comorbidity may derive from self-medication attempts, a common neuropathology for addiction and schizophrenia, the psychotogenic properties of certain drugs, or the influence of environmental factors. Among schizophrenia patients receiving treatment, substance misuse is associated with more severe symptoms and poorer therapeutic response. The presence of a chronic psychosis impedes treatment of the substance problem in traditional, nonpsychiatric addiction programs. Better outcomes are observed in integrated therapy services, where patients receive appropriate care for both conditions. Dual-pathology patients need com...

Research Proposal on Comorbid Substance Use Disorder in Schizophrenia

Mental health practitioners rely heavily on new and upcoming research and theories when determining the best course of treatments for the disorders that their patients have. Therefore it is important for them to have a comprehensive framework under which they can base their therapeutic practice in a way which would best resolve the issues that their client has. A big problem when comorbid substance use disorders and schizophrenia occur is that there is no wide consensus how to best go about tackling the symptoms of these disorders. Blanchard (2000) has proposed a model which attempts to explain the comorbidity in terms of individual personality characteristics. Due to its relatively recent nature, the model has some scientific backing, but not enough for it to be generalisable and valid enough for mental health practitioners to work under its frame of thought. The research I propose here is a longitudinal study which is built around Blanchard's Affect Regulation Model of substance addiction in schizophrenia. Hopefully, by controlling for the confounding variables which as of today have made current research not fully congruent and in accordance with Blanchard's theory, this study will aid us in better understanding the role that individual characteristics play in the development of this type of comorbidity. Introduction: